Background Nailfold capillaroscopy is able to evaluate microcirculatory damage in many different diseases and a high prevalence of capillary abnormalities has been reported in systemic lupus erythematosus (SLE).
Objectives Considering that the vascular involvement is of primary importance in antiphospholipid syndrome (APS), it can be of interest to examine the capillaroscopic features of those SLE patients having secondary APS.
Methods 29 SLE patients entered the study, 13 had secondary APS (M/F = 1/12; mean age = 45.5 yrs; mean disease duration = 5.85 yrs) while the other 16 patients (M/F = 1/15; mean age = 36.6 yrs; mean disease duration = 7.2 yrs) had no clinical or laboratory signs of APS. There were no significant differences regarding the number of ARA criteria or ECLAM and SLEDAI scores between the two groups.
Each patient underwent nailfold capillaroscopy to detect the following abnormalities: morphological alterations of capillaries, variability of capillary loop lenght, presence of microhaemorrages, irregular distribution of capillaries and sludging of blood. Moreover to score these changes a semiquantitative rating scale was adopted, according to previous studies.
Results Although not statistically significant, more frequent variability of capillary loop lenght (77% vs 44%), presence of microhaemorrages (23% vs 12.5%), sludging of blood (23% vs 12.5%) as well as capillaroscpopic score >1 (77% vs 44%) were found in patients with SLE/APS respect to those with SLE alone.
However in our SLE/APS patients the presence of capillaroscopic microhaemorrages was significantly associated to thrombocytopenia (p < 0.034) and the finding of shorter capillary loop length was related to the occurrence of livedo reticularis (p < 0.05).
Conclusion Thus we suggest that nailfold capillaroscopy can be useful to better define SLE patients with APS, helping to identify some microvascular changes that seem related to clinical and laboratory features of APS.
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